Kaelan Dawson, NP-BC
Individual provider Active NPI Acute Care Nurse Practitioner · Athens, GA
NPI 1114555083 · NPPES record last updated Jul 17, 2024
Key facts
- NPI
- 1114555083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 2019046635 (GA)
- Practice address
- 775 Sunset Dr
Athens, GA 30606-2211 - Phone
- (706) 425-1500
- NPI assigned
- Mar 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 99
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211129000468 | GA | Practitioner - Nurse Practitioner | 9133519523 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019046635 | GA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Cancer & Blood Center LLC | Current |
Accepting new patients | |
| Elbert Memorial Hospital | Current |
Accepting new patients | |
| Elbert Memorial Hospital | Current |
Accepting new patients | |
| Elbert Memorial Hospital | Past | Accepting new patients | |
| Hospice Advantage, LLC | Past | Accepting new patients | |
| University Health Alliance | Past | Accepting new patients |
Locations
3320 Old Jefferson Rd
Ste 600
Athens, GA 30607
Phone (706) 549-4155
3320 Old Jefferson Rd
Bldg 700
Athens, GA 30607
Phone (706) 224-6348
1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520
1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100
3320 Old Jefferson Rd
Bldg 800
Athens, GA 30607
Phone (706) 353-2290
110 Mercer Pl
Commerce, GA 30529
Phone (706) 335-2302
4182 Highway 278 NE
Covington, GA 30014
Phone (678) 712-6921
119 Harmony Xing
Ste 1
Eatonton, GA 31024
Phone (762) 220-1880
4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527
1087 E Franklin St
Ste D
Hartwell, GA 30643
Phone (706) 283-3151
1029 E Franklin St
Ste D
Hartwell, GA 30643
Phone (706) 213-3151
1089 E Franklin St
Ste D
Hartwell, GA 30643
1029 E Franklin St
Ste D
Hartwell, GA 30643
Phone (706) 283-3151
355 Clear Creek Pkwy
Ste 2007
Lavonia, GA 30553
Phone (706) 356-2934
2151 W Spring St
Ste B200
Monroe, GA 30655
Phone (770) 267-0724
3991 Highway 78 W
Ste 102
Snellville, GA 30039
Phone (706) 715-2010
1656 Falls Rd
Ste B
Toccoa, GA 30577
Phone (706) 886-0392
1460 Resurgence Dr
Watkinsville, GA 30677
Phone (706) 715-2410
295 N Broad St
Winder, GA 30680
Phone (678) 963-0939
Interoperability endpoints
- kaelan.dawson.1@13373.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 2019046635 | GA | Yes |
Addresses
Primary practice location
775 Sunset Dr
Athens, GA 30606-2211
Mailing address
3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400
Phone (706) 353-2990
Other practice location 1
3320 Old Jefferson Rd Bldg 800
Athens, GA 30607-1400
Phone (706) 353-2990
Other practice location 2
1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 353-2990
Other practice location 3
1230 Baxter St
Athens, GA 30606-3712
Phone (706) 353-2990
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2019046635 | Medicaid | GA |
Other providers in Athens, GA
- Jackson Davis
- Samantha Davis
- Shane Brinson Davis
- Thomas A. Davis
- William Davis
- DC Anesthesia, LLC
- Albert R De Chicchis
- Reyes Juan De Leon Payano
- Alice M Deal
- Suzanne Deal
All providers in Athens, GA · Acute Care Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.